Referral to telephonic nurse management improves outcomes in women with gestational diabetes.
We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing.
There was medical center-level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes.
Compared with women from centers where the annual proportion of referral nurse management was <30%, women who delivered from centers with an annual referral proportion >70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57-0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56-3.42, respectively).
Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. Assiamira.Ferrara@kp.org
SourceAmerican journal of obstetrics and gynecology 206:6 2012 Jun pg 491.e1-5
Glucose Tolerance Test
Infant, Low Birth Weight
Referral and Consultation
Pub Type(s)Evaluation Studies
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.